Barriers and facilitators to HIV and viral hepatitis testing in healthcare settings in Kyrgyz Republic: Protocol for a mixed-methods study (Preprint)

BACKGROUND In Kyrgyz Republic, it is estimated that 18% of people living with HIV (PLHIV) are undiagnosed, and more than half are diagnosed late (CD4 count OBJECTIVE Our aim is to identify and describe the most important barriers and facilitators to HIV and viral hepatitis B, C and D testing from the perspective of HCWs working in primary healthcare settings in Kyrgyz Republic. METHODS A cross-sectional, mixed-methods study will be conducted in two phases. A purposive sampling approach will be applied to recruit HCWs in primary healthcare settings. In Phase I, in-depth, semi-structured interviews will be conducted with up to 20 participants to gather detailed information about the key barriers and facilitators for testing. We will apply a thematic approach for qualitative analysis. Themes identified will inform the development of a short questionnaire with main barriers and facilitators for Phase II. The questionnaire will be distributed electronically, and the target sample size is 400 participants. We will perform descriptive analyses of the questionnaire data reporting the most frequently reported barriers and facilitators for HIV and viral hepatitis testing. RESULTS The study received financial support in the framework of the Global Health Protection Programme by the Federal Government of Germany. Ethics approval was obtained from the institutional review board in Kyrgyzstan. The results of the study are expected by the end of 2024. CONCLUSIONS The study will improve the understanding of existing barriers and facilitators to HIV and viral hepatitis testing in order to increase testing offers and uptake in primary healthcare settings in Kyrgyz Republic. Importantly, the findings will inform steps to improve the implementation of the new testing strategy and ultimately increase the number of people diagnosed and treated in the Kyrgyz Republic. CLINICALTRIAL Not applicable